Post Treatment

If you're doing AS properly with the guidance of an oncologist, your fears og being on AS should be tempered. You're not not doing anything, you are in fact being active about your surveillance.

I'm sure doubts creep in however. I forget the exact percentage, but many men who try AS drop out as a result of psychological reasons. This is one for you to negotiate and understand.

What does your oncologist say about your doubts? I'd think sharing these with him would be very productive for you.

As far as your question, I think it depends on the doctor. The original urologist I was with whom I chose not to use because of his experience with the procedure clearly told me that he would follow me the rest of my long life and that this was one of the advantages of going with him over one of these big named "assembly lined" surgeons. I picked a big name surgeon nonetheless and found that the exact opposite was true. My surgeon is always available to be by phone or email and I continue to have visits with him and mostly his fantastic nurse once a year at this point. So I think the answer to your question really depends on the doctor.

tooyoung,

I maintain contact with both my Urologist and Radiation Oncologist. My RO sends me periodic EPIC questionnaires to monitor any sexual, urinary and rectal SEs and orders my PSA. They are both at UCLA and my updates are sent to both of them. I have a stronger relationship with my RO, who I often trade emails with.

Dr. Walsh is hardly the last word on AS, imho. The problem with any published book is that even with new editions much of it needs updating. There have been several new longer term studies of AS demonstrating its safety in younger men. I would look more to Dr. Klotz for the latest info, rather than Dr. Walsh.

AS programs vary a lot and no one really knows which is the best program or if there is a single best program. I think that periodic multiparametric MRI or color doppler ultrasound imaging with or without biopsy can help add to confidence that the cancer is not growing. Klotz believes that it is not necessary to come off AS until some Gleason 4+3 is detected on biopsy or the PSA doubling time falls to less than 3 years. Others have more stringent criteria.